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n <br />r <br />I <br />r <br />I <br />L <br />the Evergreen <br />CITY OF <br />everett <br />CITY HALL 259.8745 <br />EVERETT. WA 98201 <br />CONSTRUCTION <br />PERMIT <br />❑ COMBINATION El BUILDING I.1 MECHANICAL <br />PERMIT NO. 11595 <br />LJ PLUMBING <br />OWNLH MAIL AUUIIL. L111 [II' VHVNL <br />The Flame Tavern 4202 Rucker Everett 98201 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE A <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE <br />Natural Gas Equipment 1Gll East Grand Everett 98201 258-2441 <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSEE <br />CUSS OF WORK <br />❑NEW OADDITION ❑ALTERATION ❑RLPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br />f <br />PROPOSED USE OF BUILDING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP - <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br />ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br />HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br />PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO- <br />VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br />CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGN ATURE0FI �CONTRACTOR OR AUTNDRUED AGENT DATE <br />X. IU.�IA, 3/16/83 <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIES) <br />LOT -BLOCK -OF <br />JOB ADDRESS <br />4202 Rucker <br />PLUMBING <br />MECHANICA <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />AIR COND. UNRS — H P. EA <br />_ <br />BATHTUB <br />REFRIGERATION UNITS — N.P. EA <br />LAVATORY (WASH BASIN <br />BOILERS — H.P. EA. <br />SHOWER <br />GAS FIRED A . UNITS —TONNAGE EA. <br />KITCHEN SINK B DISP. <br />FORCED AIR SYSTEMS — B T U. M EA. <br />DISHWASHER <br />WALL HEATERS— B. T.0 M <br />LAUNDRY TRAY <br />UNIT HEATERS — BTU. M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />WATER HEATER <br />CLOTHES DRYERS <br />URINAL <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />RANGE HOOD <br />FLOOR DRAIN <br />AIR HANDLING UNIT — C F.M. <br />VACUUM BREAKERS <br />STOVE <br />ROOF DRAINS — RAINLEADERS <br />METAL FIREPLACE 8 CHIMNEY <br />_ <br />SINK(SERVICt — BAR. ETC) <br />1 <br />Water Heater <br />4 <br />50 <br />SUB TOTAL <br />SUB TOTAL f <br />4 <br />50 <br />PERMIT <br />f <br />PERMIT f <br />TOTAL FEE <br />$I <br />I <br />TOTAL <br />FEE IF <br />14 <br />150 <br />SIDE YARD SETBACK <br />STREFS SETBACK <br />REAR YARD SETBACK <br />PLAN CHECK NUMBER <br />PLAN CHECK <br />ILL <br />FEE <br />RECEIPT NO. <br />USE ZONE <br />LOT AREA <br />VACANT SITE <br />OYES ONO <br />FEES <br />VALUATION <br />FEE <br />TYPE OF CONST <br />OCCUPANCY GROUP <br />NO OF DWELLING UNITS <br />BUILDING <br />SIZE OF BLDG. <br />NO. OF STORIES <br />MAX. 001 LOAD <br />PLUMBING <br />FIRE ZONE <br />EASEMENT <br />FIRE SPRINKLERS <br />REQUIRED <br />DYES LINO <br />MECHANICAL <br />14 <br />50 <br />APPROVALS <br />BY <br />DATE <br />OTHER <br />1. ENVIRONMENTAL CHECKLIST <br />PENALTY <br />U.BC <br />SEC. 303(a) <br />2. BUILDING PLANS <br />3. FIRE HYDRANT <br />TOTAL <br />14 <br />5 0 <br />4. FIRE PROTECTION SYSTEM <br />SGRADING <br />. <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />Lf <br />4 5 4 0 S 014.5 0 —Cr, <br />LC <br />A <br />YOUR R E C L I r l <br />THANK YOU <br />% <br />6. DRAINAGE <br />7 ENVIRONMENTAL IMPACT STATEMENT <br />8. HEALTH DISTRICT <br />APPLICATION ACC. BY <br />PLANS CHECKED BY <br />I <br />APPR. FOR ISSUANCE SY <br />. <br />ADDRESS FILE <br />6 uaa 83 <br />i <br />i <br />1 <br />J <br />L <br />.J <br />